Association between high-sensitivity troponin T and cardiovascular risk in individuals with and without metabolic syndrome: The ARIC study

Yashashwi Pokharel, Wensheng Sun, Dennis T. Villareal, Elizabeth Selvin, Salim S. Virani, Chiadi E. Ndumele, Ron C. Hoogeveen, Josef Coresh, Eric Boerwinkle, Kenneth R. Butler, Scott D. Solomon, James S. Pankow, Biykem Bozkurt, Christie M. Ballantyne, Vijay Nambi

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Background: Metabolic syndrome (MetS) is associated with increased risk for cardiovascular disease, but there is heterogeneity in this risk. We evaluated whether high-sensitivity troponin T (hs-cTnT), a marker associated with cardiovascular disease, can stratify risk in MetS. Methods:We evaluated associations between MetS (and groups with similar number of MetS components) and incident heart failure hospitalization, coronary heart disease, stroke and death using hs-cTnT categories after adjusting for risk factors/markers between 1996 and 2011 in 8204 individuals in the Atherosclerosis Risk In Communities study. Results: The mean age of the population was 63 years (56% women, 19% Blacks). hs-cTnT levels were higher with MetS and with increasing MetS components. In individuals with MetS, higher hs-cTnT levels were associated with increased hazard ratios for heart failure, coronary heart disease and death. Within each number of MetS components, higher hscTnT was associated with progressively higher heart failure, coronary heart disease and death hazards. The association was particularly strong for heart failure. With increasing hs-cTnT categories, the hazard ratios (95% confidence interval) for heart failure in individuals with MetS increased gradually from 1.68 (1.31-2.16) to 3.76 (2.69-5.26) (p-trend<0.001) compared with those with MetS and hs-cTnT<5 ng/l; and respective hazard ratios with increasing hs-cTnT categories in those with all five MetS components ranged from 2.22 (1.17-4.21) to 4.23 (1.89-9.50) (p-trend 0.004) compared with those with all five MetS components and hs-cTnT<5 ng/l. However, mostly there were no significant interactions of hscTnT with MetS or its components. Conclusion: hs-cTnT is useful for identifying MetS patients with increased hazards for coronary heart disease, death and particularly heart failure.

Original languageEnglish (US)
Pages (from-to)628-638
Number of pages11
JournalEuropean Journal of Preventive Cardiology
Volume24
Issue number6
DOIs
StatePublished - Apr 2017

Bibliographical note

Publisher Copyright:
© The European Society of Cardiology 2016.

Keywords

  • Coronary heart disease
  • Heart failure
  • High-sensitive troponin T
  • Metabolic syndrome
  • Risk stratification

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